06090011 (2) CITY OF CUPERTINO
BUILDING DIVISION PERMIT �C1R�.f.�'TC :I �4MA ,�Q` 1
BURRING ADDRESS: LINDY ROOFING CO INC PERMIT NO.06090011
10401 OAKVILLE AV
OWNER'S NAME: PERMIT ISSUE DAB
SAYRE KENNETH A AND JULIE 5554 HARVARD DR "/01/2006
NE: SANITARY NO. CONTROL NO.
(408) 286-9990
ARCHfBC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECTPLUMB MECH
O
�Op LICENSED CONTRACTOR'S DECLARATION Job Description
I hamby affirm and I am ImnsM uraer prowivau of Chapmr 9(commencing —
_ with Section 70M)of Division 3 of the Business and Professions Code,and my license is 'RE—ROOF REMOVING EXISITING SHAKE ROOF, ISTALL
Z Luc. C au LmAk
Do con 30LB FELT 1/2" OSB & 40 YEAR COMP SHINGLES CLAS
ARCHITECTSDECLARATION
I undersand my plan dull he ued u public rtcords
r U
c Licensed aterlyProfessional
tN� to,OWNSR,BUILDER
omptfr DECLARATION
i a I hereby,Isco Not 11. uemPr(ram tiro ConcamCa License Law far the
:p e fallowing moan, emit t 7031.5.I.S. t,aluesa and Professions Cole:Any dry or manly
$�i which requires;•permit re cmuruet.Ater.nt rmw,demolish.or repair any umclure
shy
prior msliccn dpuramn,totnNovisiosoftheComrot such ents'sUto l.L.(Chipe9 Valuat 8000
•�<
met hea romancing with
paemam to No provisions of the Co^uacbr'a Limnmlaons Codtor9 Sq.Ft.Floor Area
i�' (co he isromithSemon 7000)nandte,hu fanth3 of aleedco plon,Mnd ionsCade)of
3 Shat he u 31.5 b therefrom and the aper for the alleged estmPrim Any adalulon of ppN N ptb
Section 7W 1.5 five
airy applicant s(a permit objects the applWnt m a dull penally of 3 6912 l�.i .r 0 0 Occupancy Tyre
cot more than Bw huMrtd dollen(5500).
❑I,u owner of the property,or my employees with wages u their sou compensation,
won do the work and the structure is not intended or offered for sale(Be.7044,Insides Required Inspections
and Professions Cade:The Outcomes Lim=law does ant apply In an Owner a e q P
.a employ buildstted thaloch im rove who deesamhwork hiouaforthmugh he
owneer.theuiprovidedmar veh improvements old
saenot Ioutof ar ffered icton.(mule r.
however..Ne building become
is hold within one you of complmon,the owed
builder will love the aortico of proving that he did not Wild or Improve for purpose of
sale... 9l
❑Lumatter of the Property,.B exclusively and c^nutans with RmmeCm^ictues U. —y
came La the project(Sea.sh th,Business and property
who
Cade:)Them themmes and
cease law dna not apply m an wither of prapenY les balms or imPmvu Nems^,cod,
who contracts for such projects with a eonuacmr(U Ilcense0 punant m the Conuotaes O
Llcenu Law. /
❑lam uempr undo See .B,t PCfar Nis rtaann `/O
Owner Data
WORKER'S COMPENSATION DECLARATION
40 1 hereby atm order penalty of Perjury one of the following declarations:
❑I haw and 4401 mantain aCertifimaaf Conant aulbinum farWmkers Compere
nem,as provided for by Section 3700 of the Labor Cade,for an,perform.of the
work for which this Permit is Wised.
❑I have and will maintain Workers Composition Insurance,u required by Section
3700 of the labor Code,for the performance of the work far which Nu permit is issued. '
My Worker's Compensation Insennm amc and Policy number am:
9\ Cartier.e7T/tr�'-�'VAQ Policy No.:j R5q�6 -0j6
CERTIFlCATEOFEKEM PTION FROM WORKERS'
COMPENSATION INSURANCE
(This auction head mo M completed If an,Permit is forone hundred dollars;($100)
or Ws)
I certify that in to performance of the work for which this perch is Wood.I shall not
employ any person in any manor so as to become object to the Workers'Compensation
Lawsof Califamia.Data
ApplQ,
NOTICE TO APPLICANT.IL after making tide Cemilau of Exemption,you should
become subject to the Worlm's Compensation provisions of me labor Code you mail
.J Q forthwith comply with such provision or Nu permit shall hm
e deaed remkcd.
z„ CONSTRUCTION LENDING AGENCY
y
[� I hereby 4IBm Neo Nem is a construction lending agency for the Performance of
C > the wart for whim this Perch Is added(Sec.3157.Cb.C.) '
U3 QLoaers Nunc
A.z Leaders Address
U0 I certify that 1 have rod this application and sum Nn the above information is
(2.P correct.1 spm to comply with all city and county ordinances and sou laws¢Wing to
OU building construction,and hereby authorise representatives of mu city to enter upon the
r W above mentioned property for inspection purposes.
g� (We)agree to save,indemnify and keep hamlets the City of Cupertino against
rF.r y liabilities,judgmenta,cosu and expenses which may in my way seem,against said City
U in APPLICANT UNDEof the RSTANDS Awung of rs rmit,
ND WILL COMPLY WITH ALL NON-POINT Issued by: Date GC
SOURCE REGULATIONS.
I1Y /�4 s a fO Re-roofs
r<afApplimnUCaroamer Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building m ement more or handle huardou materia
as dalmd by the Cupertino Manldpal Code,Chapter 9.12.and the Heath and Safety
Coda,Such.25532(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yes _AI Nu
Will Shu applicant or furore building rampant iso equipment as'deacu which40
If a roof is installed without first obtaining an inspection,I agree to remove
.mit ba.nhu a air contaminants at dellned by the Bay Arca Air Quality Management all new materials for inspection.
District?
❑Yns ACW'
I hoc mad the huardous materials requimmcnu under Charter 6.95 of the call(.,.
.is Health h SacoyCode.Suction 25505,25533 and 25534.1 undersand muff the Wilding
don an,currently haw a u nano that It is my responsibility in ratify the omupant of the
requirements which most lx met Prior m issuance of a Cansfcamof mpamy. Signature of Applicant Date
IRA,oumorizcd-ogLcnl �^ r /_pDamAll roof coverings to be Class"B" or better
r o ' '
Community Development
M 10300 Torre Avenue
Cupertino CA 95014.
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
*UPERTINO
Building De utment
JOB ADDRESS:/e)yp/ 00-eV1 ((Q PERMIT #
060 Qool/
OWNER'S NAME: 11-en � .Ju) L,Q. Sq - PHONE # o g�S(a `/a
GENERAL CONTRACTOR L t Y.- L /2mo�in FAX # CP -
I am not using any subcontractors: J0 71 _ L,--)Q . t o -Y UAy
Signature Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
• Linoleum/ Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
•
Owner/Contractor Signature Date
Community Development Department
Building Division
j City of Cupertino
• 10300-Torre Avenue
ITY
COF relephone: (408) 777-3228
CUPEi�TINO Far: (408) 777-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance, you must agree to comply with 1997 UBC Standards
and manufacturers specifications on re-roofing.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to any roofing installation.
4. To receive a final sign off from the City, the following steps are
required:
1) Pre-inspection and/or tear off approval.
2) In-progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
' S. If plywood is installed, a plywood nail inspection is required.
6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be performed.
7. NOTE: If you call for a plywood nail inspection and the job is not ready,
you will be charged a re-inspection fee of$176.18. The re-inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a nnininnum of 1/4 " per foot slope and demonstrate
that there is no ponding.
2. An 1.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Flame: A ' e% 4' fGc h( Svr-e .
Job Site Address: /O /-/O( eae r/r l Le 141. �
Roofing Company Name: L i nL lc/ filo-4n-1 Co •
Applicant'sSignature:--O :!:�2 Z/�V _ Date: x'31-fes
' Greg Casteel
Building Official
Revised 11/2/04
Prinlod on Recycled P}oer
CITY OF CUPERTINO
am 1 of 2 PERMIT RECEIPT OPERATOR: amyw
COPY # 2
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 36912032 . 00
DATE ISSUED. . . . . . . : 09/01/2006
RECEIPT # . . . . . . . . .. : 35888
REFERENCE ID # . . . : 06090011
SITE ADDRESS . . . . . : 10401 OAKVILLE AV
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SAYRE KENNETH A AND JULIE I
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : ,
RECEIVED FROM . . . . : LINDY ROOFING
CONTRACTOR . . . . . . . : RUMFORD, LINDY LIC # 3921
COMPANY . . . . . . . . . . : LINDY ROOFING CO INC
ADDRESS . . . . . . . . . . : 5554 HARVARD DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95118
TELEPHONE . . . . . . . . : (408) 286-9990
•FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
--- ---- --- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 9, 000 . 00 158 . 76 0 . 00 158 . 76 0 . 00
BSEISMICRE VALUATION 9, 000 . 00 0 . 90 0 . 00 0 . 90 0 . 00
-------- -- ---------- ---------- ----------
TOTAL PERMIT 159 . 66 0 . 00 159 . 66 0 . 00
•
" CITY OF CUPERTINO
REROOF 9�7
CUPERTINO PERMIT APPLICATION FORM
APIC# (y_'2. _03 2 Date:
—1 X31-O�p
Building Address: 10 40 ( 0 i 1-e A-V e—
Owner's Name: Phone
den c t/v ,252-5,a8/
Contractor: Phone #: License#:
,LwrtdLl JR.ao5tii L{O 8 a.*V6 -9?`YD .
Cont4ct: Phone#: Cupertino Business License #:
�' a, 9 94+7
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles �/ Asphalt Shingles
�:Qf Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O.Report#
)k To be Removed ❑ Provide Mfgr. Installation Specs.
I Have Read Understand and Will Comply With Cu ertino's Tear Off Policy:
yobsct Deription. refnOvtns •�� aY2 road rnsf a �tf 30 2" 0 B �—
Residential Commercial ❑
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: LJ
Cost of Project: Type of Construction: Occupancy group:
C? -50- e _r oo-r
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING